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Pulmonology > Bronchial CA > Flashcards

Bronchial CA Flashcards

1
Q

Main risk factors of bronchial CA

A
  • Cigarette smoking
  • Passive smoking (1.5 times greater)
  • Occupation exposure – arsenic, chromium,
    iron oxide
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2
Q

Main two types of bronchial CA

A
  1. Small cell CA – 3 years, initial malignant
    change to presentation
  2. Non-small cell CA – 15 year for Adeno CA, 8
    years for squamous CA
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3
Q

Non small cell CA types

A

Squamous CA
Adeno CA
Large cell CA
Bronchoalveolar CA

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4
Q

Early presentation type of bronchial CA

A

Small cell CA

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5
Q

Most common Bronchial CA type

A

Squamous CA

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6
Q

CA seen in almost exclusively in smokers

A

Squamous cell CA

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7
Q

Central and cavitating type of bronchial CA

A

Squamous cell CA

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8
Q

Presentation of squamous CA

A

Obstructive lesion to bronchus presenting as infection

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9
Q

squamous cell CA is well differentiated (T/F?)

A

True

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10
Q

Local spread is common in Squamous cell CA

A

True

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11
Q

widespread mets are common in small cell CA

A

False. It’s rare

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12
Q

AdenoCA is mostly peripherally located

A

True

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13
Q

Adeno CA arises from mucous cells from the alveolar epithelium

A

False. mucous cells from the bronchial epithelium

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14
Q

Adeno CA most common invading sites

A

Invasion to pleura, mediastinal lymph
nodes, metastasis to brain, adrenal gland
and bones

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15
Q

Adeno CA is mostly associated with….

A

non- smokers and asbestos

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16
Q

what is the less differentiated forms of squamous cell CA and adeno CA

A

Large cell CA

17
Q

bronchial CA that presents as diffuse or solitary nodules

A

Bronchoalveolar CA

18
Q

Location of small cell CA

A

Central and apical

19
Q

SSC arise from…. cells

A

Endocrine cells aka Kulchitsky cells aka APUD cells

20
Q

SSC are easily operable at the time of presentation

A

False. Almost inoperable. early spread

21
Q

Does SSC respond to chemo and radiotherapy

A

Yes

22
Q

Clinical features of Bronchial CA

A
  • Cough
  • Chest pain – pleuritic pain
  • Haemoptysis
  • Malaise
  • Weight loss
  • Hoarseness of voice
  • Signs of pleural effusion, collapse
23
Q

Sites of direct spread

A

pleura, ribs
CA apex- lower part of brachial plexus
Hilar tumors- RLN
Phrenic nerve
Superior Vena Cava
Esophagus

24
Q

Manifestations of direct spread to the CA apex

A

horner’s syndrome

25
Q

manifestations of direct spread to the hilum

A

RLN involvement causes U/L vocal cord paresis, hoarseness, bovine cough

26
Q

Manifestations of direct spread of bronchial CA to the Superior vena cava

A

early morning headache,
facial congestion and oedema of upper
limbs

27
Q

Metastatic complications of bronchial CA

A
  • Bone metastases (pathological fractures)
  • Liver involvement
  • Brain involvement
  • Spinal cord compression
  • Adrenal involvement
28
Q

Sx of Liver involvement of direct spread of bronchial CA

A

RHC pain
LOA
Icterus is a very late sign

29
Q

Sx of Brain involvement of direct spread of bronchial CA

A

early morning headache
vomiting
adult- onset seizures

30
Q

Non-metastatic extrapulmonary
manifestations is also known as

A

paraneoplastic syndrome

31
Q

Paraneoplastic syndrome in bronchial CA

A
  • Finger clubbing
  • Hypertrophic pulmonary
    oesteoarthropathy
  • Metabolic – loss of weight, anorexia
  • Endocrine – usually small cell CA
    o Ectopic ACTH secretion
    o SIADH
    o Hypercalcaemia – usually squamous cell
    CA
  • Neurological
    o Encephalopathies (cerevellar
    degeneration)
    o MND
    o Peripheral sensorimotor neuropathy
    o Muscle disorders
    o Lambert Eaton syndrome
  • Vascular
    o Thromboplebitismigrans
    o DIC
    o Haemolytic anaemia
  • Cutaneous (rare)
    o Dermatomyositis
    o Acanthosis nigricans
32
Q

Ix done for Bronchial CA

A
  • CXR
  • CECT
  • Fiberoptic bronchoscopy
  • Percutaneous aspiration and biopsy
33
Q

Mx of bronchial CA

A
  • Surgery – can be curative in non-small
    cell lung cancer
  • Radiation therapy for cure (Radiation
    pneumonitis)
  • Chemotherapy
  • Laser therapy, endobronchial irradiation,
    Stents
  • Palliative treatment
34
Q

Clubbing DDs

A

CVS - Cyanotic HD, Atrial myxoma, Inf endocarditis

Respi- Bronchiectasis, Lung Abscess, Bronchial CA

Pulmonology (13 decks)

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